Tennessee Technological University Foundation
In-Kind Report Form
Report Initiated By:
TTU: A Constituent University of the Tennessee Board of Regents/342-WEB-08/An EEO/AA/Title IX/Section 504/ADA University/Revised: 05/08
University Advancement
Submit form to Oce of University Advancement, Box 5111.
No item can be accepted until the In-Kind Form is approved through University Advancement.
Submission/Acceptance:
The person signing as Chair/Supervisor will be responsible for insuring receipt of item(s) after acceptance approval process is completed.
Submitted By: ________________________________________ Reviewed By: _________________________________________
Approved By: ________________________________________ _________________________________________
Approved By: ________________________________________ Approved By: _________________________________________
All In-Kind items should have the following:
________ In-Kind Form completed
________ Copy of Appraisal from Donor or
________ Statement of Value from Donor or Dept. Expert or
________ Itemized receipt (if item is new)
________ If computer hardware/software, signed by
Associate Vice President of Information Technology
________ If library materials, signed by Director of Library
Employee Name: _____________________________________________ Phone: _______________________ Date: _________________
Donor Information: (If company donor, please enter company name and contact name below.)
$5000+ items must ALSO include:
________ 3rd party (independent of TTU) appraisal with
appraiser qualications
________ If specialized (only manufactured by the company
donating) attach published price list from the
internet, or publication showing the price of each item
Department Chair/Supervisor Date
Assoc. Vice President, ITS; or Director of the Library Date
Dean/Director Date
Associate Vice President of University Development Date
Director, Advancement Services Date
Vice President of University Advancement Date
Company/First Name: ___________________________________ Middle Name/Initial: ______________ Last Name: ____________________
Address: ____________________________________________ City: _________________________ State: _________ Zip: ___________
Spouse Name (or Company Contact): _________________________ Phone: _______________________ E-mail: _______________________
Donor’s Aliation with TTU: _______________________________ Split or Dual Credit (if other than spouse): _____________________________
Information: (Must be completed.)
Description: ___________________________________________________________________________________________________
Estimated Value: _____________________________________ Account Name/Number: ___________________________________________________
School/Department: ____________________________________________ If In-Kind from Company, is this a company product? New or Used?
Were goods and/or services provided in exchange? If value is $5000+, will item be sold within three years?
Should this item be transferred to the University for inventory purposes? The item will be used for: ____________________________________________
Potential Liability for University or Foundation: ________________________________________________________________________________________________
Restrictions and/or
Additional Comments:
TTU provides no appraisal for tax purposes; any amount listed below is for recognition use only.
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